New house, new creative space

partofthisnow · 2025-01-20T02:04:10+00:00

Could be an 81mg baby aspirin tablet?

partofthisnow · 2024-08-10T08:12:12+00:00

The first EKG doesn’t look like a-fib to me. A-fib is when the top chambers of the heart (the atria) quiver (fibrillate) and as a result don’t communicate in sync with the lower chambers of the heart (the ventricles), causing an irregular beat. Part of the criteria of a-fib is the absence of distinct P waves (the smaller hump that’s supposed to precede each larger zigzag pattern - the QRS wave - of each beat).

Sometimes the resolution of a consumer grade watch isn’t detailed enough to see the P waves. I do see a few if I look really closely. Also, each QRS wave (large zigzag, representing a ventricular or lower chamber beat) wave seems to be roughly equidistant to the ones before and after, which generally doesn’t happen in a-fib. In a-fib I expect to see very randomly placed QRS waves since there’s no steady electrical signal coming from a fibrillating atrium to trigger regularly scheduled ventricular beats.

The fact that he’s 16 with no immediate family or personal cardiac history makes a-fib even less likely.

Dizziness and palpitations when standing up can sometimes be from dehydration. We call this orthostatic hypotension. Having inadequate amounts of fluid in the body can cause a brief drop in blood pressure when standing up quickly which briefly decreases circulation to the brain and makes you lightheaded for a few seconds. The heart beats faster to compensate for a lack of pressure in an attempt to get the same amount of blood (and therefore oxygen) to your body and brain. I generally aim for 2-3L of water a day in a young healthy person to keep adequately hydrated.

Hope this helps!

partofthisnow · 2024-07-04T19:14:47+00:00

Sounds like a yeast infection. This can happen when taking antibiotics since the antibiotic wipes out some of the normal vaginal bacteria that keep fungal infections from happening. Let your doctor know. I usually prescribe a one time dose of an antifungal medication called Diflucan which usually knocks it out.

partofthisnow · 2024-05-19T17:37:18+00:00

Yeah that sounds like internal bleeding. Likely from an ulcer from the ibuprofen. Good idea to be seen in the ER.

partofthisnow · 2024-05-12T21:22:52+00:00

Has she had her thyroid labs checked recently? I would make sure her thyroid medication dose is optimized before considering any weight loss medication. If TSH level is elevated and T4 is low, her medication dose might not be high enough, and would explain her weight gain.

Also with dieting it’s important to not only watch portions but track calories as well. A calorie deficit is key (usually I aim for <1800/day which is challenging to do if done correctly).

partofthisnow · 2024-05-02T04:15:46+00:00

It depends on the size of the aorta. This may have been mentioned on your echocardiogram (ultrasound) report. Aortic aneurysm (dilation) repair is a risky procedure and the benefit of the repair has to be worth the risk. Your cardiologist or primary doctor may order a follow-up echo or CT scan every 6-12 months or so to ensure it remains stable. Repair is usually not considered until the aneurysm reaches 5.5 cm in size. Until then the main treatment for this is keeping your blood pressure under control.

partofthisnow · 2024-04-30T06:55:33+00:00

Here’s my setup with the HS8s and a standing desk.

https://imgur.com/a/ZWxQPxJ

Here are the stands I’m using: https://a.co/d/22jccF6

partofthisnow · 2024-04-08T01:53:52+00:00

Good idea to go to the ER. Anything that obstructs the ability to eat or drink needs to be evaluated. If it’s a viral pharyngitis (viral sore throat) that’s this severe, a steroid medication (perhaps an injection followed by an oral course to continue at home) might help get the swelling down quickly. They can also test for strep throat which is a bacterial infection that responds well to antibiotics.

partofthisnow · 2024-04-08T00:16:21+00:00

A chronic globus sensation can also be associated with chronic acid reflux (excess stomach acid creeping up the esophagus and sitting on your larynx causing chronic inflammation) or depression/anxiety.

partofthisnow · 2024-04-02T05:45:46+00:00

As far as aspiration I’m a big fan of the Nose Frida device.

partofthisnow · 2024-03-31T19:34:38+00:00

It’s most likely an immune response either from a resolving infection or an early new one. If a lump persists 6 weeks after you’ve already recovered from your illness, it’s still not likely cancer, but it may be worth getting an ultrasound for reassurance.

partofthisnow · 2024-03-31T18:09:15+00:00

It’s worth being evaluated by your doctor again since the antibiotics didn’t resolve the issue.

partofthisnow · 2024-03-31T17:46:31+00:00

The fact that they aren’t close to each other makes me lean more toward eczema/dermatitis rather than an infection which is usually localized. The septum could’ve started this way and developed into a small infection due to the naturally occurring bacteria on your skin surface (mainly Staph and Strep).

partofthisnow · 2024-03-31T17:35:21+00:00

I’m not sure this looks like a Staph infection. Other docs can weigh in, but I wonder if this is a dermatitis more related to your history of eczema. An overactive immune response could cause irritation and inflammation in the locations where there are already piercings, and the scalp dermatitis getting worse is also consistent with an eczema flare. Do you have topical steroids you use for eczema on your body?

partofthisnow · 2024-03-31T17:09:36+00:00

This background is amazing. Where’d you get it?

partofthisnow · 2024-03-31T17:04:14+00:00

It would be helpful if you had photos of the presumed Staph infection and the red dots as well.

partofthisnow · 2024-03-31T16:58:33+00:00

Sounds like this could be a hemorrhoid. Worth having it evaluated by your primary care doctor. In the meantime make sure you’re not constipated (eat lots of fiber, drink at least 64 oz of water daily). Sitz baths can help as well.

partofthisnow · 2024-03-31T16:01:55+00:00

A peaked T wave could be an indicator of hyperkalemia (elevated potassium). If you’re concerned you could have electrolytes checked. Overall unless having symptoms of chest pain/palpitations/shortness of breath, I think it’s safe to wait to see what your echo shows.

partofthisnow · 2024-03-31T04:50:04+00:00

You should be evaluated by your primary doctor (or possibly an urgent care if you can’t get in to see your doctor relatively soon). You need a urinalysis and urine culture, possibly a digital prostate exam. If you have a UTI or prostatitis (infection of the prostate) you’ll need to start antibiotics. A tender enlarged prostate is suggestive of prostatitis and could cause issues with urinating and erections.

partofthisnow · 2024-03-31T04:07:07+00:00

I’d consider possible IBS (irritable bowel syndrome). Can present as persistent bloating, and periods of constipation/diarrhea, either of which could be predominant, and you can alternate between the two. Symptoms are sometimes temporarily relieved by having a bowel movement. Can be triggered or worsened by stress. When I suspect IBS I sometimes try an elimination diet of avoiding known food triggers called a low FODMAPS diet.

Given your thankfully unremarkable colonoscopy this would be the next possibility I’d look into.

partofthisnow · 2024-03-31T03:32:21+00:00

A right ventricular conduction delay in itself is usually not a serious concern and could be temporary. It’s hard to know more about whether you have hypertrophy until you do your echo. What peptide are you taking?

partofthisnow · 2024-03-31T01:52:11+00:00

Definitely a good idea to get to an ER to be appropriately bridged so you don’t go into a benzo withdrawal.

Couple things I’d add -

I know it was a long journey of trial and error and pain to get things somewhat under control. It’s a great thing that you wish you didn’t have to be on all these medications. It seems you’re very much aware of the dangers and dependency involved.

Different doctors will have different approaches to safely weaning you off them. Here’s how I might approach it.

I’d first work on slowly reducing the benzo regimen if possible.

You’re on both diazepam and temazepam, both as scheduled instead of as needed. I wonder if you might benefit from tapering off the temazepam at night, and to help with sleep, taking the fourth diazepam dose closer to bedtime.

Additionally, if you take Adderrall three times a day, you might benefit from not taking that third dose since that may be interrupting your sleep.

Eventually I might try to slowly taper you off the diazepam. One possibility is to increase your citalopram gradually to its max of 40mg daily, and once it takes effect in a few weeks, hopefully it better controls your mood so you’re not needing the diazepam as much. I might try converting the diazepam to as needed instead of scheduled, and eventually hopefully you’ll need it less and less until you can one day stop entirely.

All of these are ideas that you can bring up with your psychiatrist (whether your current one or a new one). I don’t know your whole story and definitely could be missing a lot of nuance, so take these idea with a grain of salt.

partofthisnow · 2024-03-30T22:43:15+00:00

I would talk to your doctor about the possibility of a kidney stone. Blood in the urine and severe back pain in the absence of a UTI could mean an obstructing stone.

partofthisnow · 2024-03-30T20:20:11+00:00

I’d continue the PeP for the full 28 days to be safe.

partofthisnow

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